Association between musculoskeletal symptoms and serum vitamin D levels in women receiving aromatase inhibitor treatment.
Bibliographic record
Abstract
e20560 Background: Up to 40% of women with estrogen positive (ER+) breast cancer treated with aromatase inhibitors (AIs) experience musculoskeletal symptoms (AIMSS) such as bone pain, joint pain, joint stiffness, and muscle weakness that negatively impact functional ability. Previous reports indicate that vitamin D insufficiency is common in this patient population and that D supplementation might attenuate AIMSS by affecting muscle, bone and/or nerve metabolism. To test the association between AIMSS and serum 25(OH)D levels, we analyzed data collected as part of a pilot prospective study assessing instrument effect sizes to measure AIMSS. Methods: Data were analyzed from 58 women, age 61 ± 10 y with a history of ER+ breast cancer stage I-IIIa. AIMSS symptoms were measured at baseline (pre AI) and 6 mo using the Breast Cancer Prevention Trial Musculoskeletal Subscale (BCPT-MS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the Australian-Canadian Hand Osteoarthritis Index (AUSCAN). Serum 25(OH)D was measured by radioimmunoassay (Diasorin liaison, Stillwater, MN). Linear regression analysis was used to determine the association between changes in AIMSS scores (dependent variables) and changes in serum 25(OH)D from baseline to 6 mo, adjusting for age and season. Results: From baseline to 6 mo there were significant increases on all AIMSS measures (BCPT-MS, WOMAC and AUSCAN p<0.02). These increases in AIMSS measures were not associated with the change in serum 25(OH)D from baseline to 6 mo (Δ =11 ng/ml ± 12; p<0.001). Conclusions: Worsening of symptoms during the initial 6 months of AI therapy was not associated with changes in serum 25(OH)D levels. These results suggest that short-term supplementation with 25(OH)D does not attenuate the symptoms of AIMSS in post-menopausal women with ER+ breast cancer during the first 6 mo of AI therapy. However vitamin D insufficiency was uncommon in this study population (mean 25(OH)D at baseline 31 ng/ml ± 10 and 42± 13 ng/ml at 6 mo). Well controlled clinical trials are needed to further our understanding of these relationships. Clinical trial information: NCT01074320.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".